I’ve worked in adult care offerings for Hertfordshire County Council for more than 11 years now – long enough to don’t forget ‘investment’ decisions when I started as assistant director.
Also lengthy enough to take into account then making some a long way greater tough selections at some stage in the austerity years that have accompanied considering 2010.
Since 2013, I was the director of grownup care services, and my colleagues and I recently looked back at the one’s years to examine how we had made savings – and then discussed our plans for the future and in which we’ll move next.
Hertfordshire’s story isn’t untypical of other regions. For the first half of austerity years, councils made savings within the following approaches. Firstly, we brought brief-time period interventions like enablement home care and short-stay beds to assist people to get lower back to independence after a stay in a health center or a coincidence at domestic. This took people out of the long-term network care populace – both home care and home care.
We additionally promoted direct bills and individual budgets as a manner of presenting desire and manipulate without the overheads that commissioned services to attract.
Also, councils additionally regarded to take value out of the care offerings they commissioned with the aid of now not supplying the inflationary will increase they had before austerity and via negotiating with care vendors to reduce care package deal expenses in which the fee didn’t appear to match the value of shipping.
Change of route
Halfway thru austerity, there was a shift in the manner councils made their financial savings. This appears to have been pushed by using the advent of the countrywide living wage for over 25s in 2016 and the authorities’ coverage to, rightly, growth that wage with the aid of more than inflation.
But that additional monetary pressure was now not funded with the aid of central authorities, so councils had to look for ever more modern approaches of reducing the quantity of care they commissioned because the price of care had closed in on the fee of delivery.
Councils seemed to improve accommodation for humans – greater community system, home adaptations, and different housing fashions. They looked at ‘asset-primarily based community improvement’ to see if humans’ eligible care wishes might be met in methods aside from thru traditional care services.
We all seemed to enhance our focused prevention offer, even as funding streams like the Better Care Fund and wintry weather grants have caused councils working greater closely with their NHS colleagues to spend their respective monies to the mutual advantage of the man or woman and the system.
The Care Act helped us to refocus our efforts on carers and personalization.
Effects of price range cuts
Taking this kind of a large amount of cash out of a device that turned into in no way generously funded inside the first location has left the care quarter under large stress.
Social care frontline workforce turnover in 2017-18 was over 30% (Skills for Care, 2018), care companies failing or handing lower back contracts to councils and the ‘big finance’ troubles, in which funding funds now very own big care conglomerates are extremely annoying.
They have a real human fee that our workforce see each day.
During the Allied Healthcare failure and next sale remaining autumn, Hertfordshire had to find opportunity care vendors for nearly 500 human beings, some with very complicated care wishes.
A new nearby authority trading enterprise to tackle domiciliary care became part of the answer – as turned into turning to our awesome relied on care company companions.
In regions like Hertfordshire, close to London and with eye-watering housing expenses for the body of workers and a scarcity of housing for absolutely everyone, those issues are compounded.
To stabilize the machine, we need to pay our care body of workers greater and offer higher phrases and conditions. Having the equal person for his or her care and help is continually people’s pinnacle priority when we ask – it’s what I could want too.
Six ‘huge ideas’ to enhance care
For the destiny, Hertfordshire has provided you with six ‘big thoughts’ to growth care satisfactory, improve human beings’ lives, and deal with much less cash:
We will retain to invest and develop our prevention provide with our fitness companions – we accept as accurate with something else is a false economy.
We will preserve to spend money on mastering and improvement for our expert team of workers within the council and our dedicated care staff in our groups (our new Care Professional Standards Academy, via our particular Hertfordshire Care Providers Association, went stay final month) – we need their innovation and compassion extra than ever.
We are commissioning our quick-term interventions collaboratively with neighborhood NHS companions to make humans’ experience of the fitness and care machine as first-rate as feasible once they need it; human beings get remedy at home along with their domestic enablement care.
Over the autumn, the council will make selections on massive funding in enhancing and lengthening its built estate to assist older or disabled human beings through masses of Flexicare Housing devices, supported dwelling, modern day possibilities and flow-on accommodation for folks who are mentally ill.
We have additionally worked on pathways to employment for disabled people and people with autism, Asperger’s, and intellectual unwell-health.
All of this is underpinned by way of our Connected Lives model – a call to movement to all 31,000 folks that work in adult social care in Hertfordshire to think about the most innovative and appropriate way to meet humans’ desires, to cause them to as independent and happy as they may be.